Metastatic Uveal Melanoma Program
The embolization procedure
After eligibility is confirmed, patients will be scheduled for embolization procedure. The type of medications that will be used for embolization will be decided based on patients’ medical condition.
Patients will be admitted to Thomas Jefferson University Hospital on the day of procedure. They will stay overnight for hydration and monitoring of their medical condition. In general, the majority of patients will be discharged to home on the following day unless they experience significant side effects from the treatments or laboratory tests show significant abnormality
On the day of treatment, patients will report to the Short Procedure Unit (9th floor of Gibbon Bldg), where intravenous fluid will be started. Patients then will be transferred to the procedure area of CVIR (5th floor of Gibbon Bldg).
Prior to the procedure, premedications for conscious sedation will be given and then a small catheter will be inserted into the Aorta via artery in the groin and angiographic study will be performed to check the anatomy of the hepatic arteries.
After this angiographic examination, the catheter will be placed into one of the hepatic arteries and medication(s) mixed with ethiodized oil will be injected into the hepatic artery. This will be followed by occlusion of the hepatic artery by gelatin sponge particles.
After the procedure, patients will be transferred to a hospital bed. Patients must lie flat in the bed for 6 hours after the procedure.
The following supportive care will be given after the procedure.
– Hydration (intravenous fluid infusion)
– Antibiotics
– Pain control
– Antiemetics (medications for nausea and vomiting)
On the following day, patients will be examined by doctors from CVIR and Medical Oncology. Blood will also be drawn for laboratory tests. If patients’ medical condition is stable and if blood tests results do not show significant abnormality, patients will be discharged.
After the discharge, patients will take antibiotics and antacid medications for 7days. They may need to take medications for nausea, fever, or pain as needed. These symptoms will usually subside within 7 days. Blood tests will be repeated once a week.
If patients do not experience significant side effects from the embolization treatment, treatment will be repeated in 4 weeks. After every two treatments, CT scan of chest, abdomen and pelvis, and MRI of the abdomen will be ordered to evaluate the response. If patients achieve stabilization of liver metastases, the embolization treatment would be given 2-8 times.
Follow up with Dr. Sato
After completion of every two treatments, CT scans of the chest/abdomen/pelvis and MRI of the abdomen will be ordered to evaluate the effectiveness of treatment. If patients participate in a clinical trial, they may be requested to obtain other tests. In that case, a research nurse for clinical trial will contact patients to give detailed instructions. Patients will also be seen by Dr. Sato to evaluate their physical condition and to discuss their next treatment. If the follow-up study shows that metastases in the liver has not gotten worse, further embolization treatment would be offered. A total of 2-8 embolization treatments would be offered. If patients do not respond to embolization treatment or if they develop extra-hepatic (outside of liver) metastases, alternative treatment options will be discussed.
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